Browse the evidence

Tirzepatide improves cardiovascular risk factors, including lipid profiles and blood pressure, without increasing cardiovascular event risk in T2DM patients.

Beyond weight loss, Tirzepatide improves heart health markers by lowering bad fats (triglycerides, LDL) and raising good fats (HDL), while also lowering blood pressure. It does not appear to increase heart attack or stroke risk in T2DM patients.

In severely obese individuals, indexing estimated glomerular filtration rate (eGFR) to actual body surface area (BSA) rather than the standard 1.73m2 reveals renal hyperfiltration, which significantly improves following medical weight loss.

If you have severe obesity, your standard kidney function test (eGFR) might be misleadingly low because it doesn't account for your larger body size. This can hide early kidney stress (hyperfiltration). Ask your doctor if they can calculate your kidney function using your actual body surface area. This method often reveals higher kidney function that improves as you lose weight, providing a more accurate baseline for your health.

When essential amino acid profiles are equated, a novel plant-based protein matrix provides equivalent benefits to whey protein for body composition, strength, power, and aerobic performance in trained futsal players over an 8-week period.

If you are an athlete consuming enough total protein (over 1.6g/kg body weight per day), the specific source of your protein supplement (plant vs. whey) does not matter for muscle gain, strength, or performance, provided the plant protein is formulated to match the essential amino acid profile of whey. You can choose plant-based options without sacrificing results.

Women with PCOS exhibit metabolic inflexibility (impaired substrate switching) comparable to women with Type 2 Diabetes, independent of BMI differences.

For women with PCOS, metabolic inflexibility is a core feature similar to Type 2 Diabetes, not just a side effect of being overweight. This means your body struggles to switch between burning fat and sugar efficiently. Focus on strategies that improve insulin sensitivity (like resistance training and managing carbohydrate timing) rather than just calorie restriction, as the underlying hormonal environment (androgens) drives this inflexibility.

Within PCOS populations, metabolic inflexibility is strongly associated with higher visceral adipose tissue and hyperandrogenemia (free testosterone/free androgen index).

If you have PCOS and struggle with metabolic flexibility, check your visceral fat and hormone levels. High free testosterone and abdominal fat are key drivers of this inflexibility. Addressing these specific markers may help improve your body's ability to switch fuel sources.

High consumption of sugar-sweetened beverages (SSB) is associated with an increasing burden of cardiometabolic mortality, with attributable deaths rising by 7.2% between 1990 and 2010, despite being a smaller absolute contributor than nuts or fruit deficits.

Cutting out sugary drinks is crucial because their consumption is rising and driving up heart and diabetes deaths. Even though other factors like low nut intake cause more total deaths, the trend for sugary drinks is getting worse, so reducing them is a high-priority action.

Physical activity increases the competitive advantage of skeletal muscle cells by depleting their stored energy (glycogen/lipids), thereby improving insulin sensitivity and reducing the partitioning of nutrients to fat cells.

Engage in regular physical activity to deplete muscle glycogen and lipids. This forces muscle cells to compete more aggressively for blood nutrients, improving insulin sensitivity and reducing the amount of energy stored as fat. This is more effective than exercise alone for weight loss because it addresses the underlying cellular competition.

Fat cell hyperplasia (increase in number) is the primary competitive strategy of adipocytes, leading to increased partitioning of nutrients to fat and poorer treatment outcomes for weight loss compared to hypertrophy (increase in size).

If you have been obese for a long time, you may have more fat cells (hyperplasia). This makes weight loss harder because each cell competes for nutrients. Consistent physical activity and dietary management are crucial to manage this increased capacity for fat storage.

Common genetic variants explain only a small fraction (12-24%) of the variation in fish and EPA+DHA consumption, with non-genetic personal and environmental factors being the principal determinants of intake levels.

Do not rely on genetics to predict or change your fish intake. The study shows that where you live, your culture, and your habits matter far more than your DNA. Focus on modifying your environment (e.g., access, availability) rather than looking for a genetic reason why you can't or won't eat fish.

GLP-1 receptor agonists (semaglutide) and dual GLP-1/GIP agonists (tirzepatide) cause significant lean mass loss during weight loss, with semaglutide losing approximately 45% of total weight as lean mass and tirzepatide losing 25.7%, posing a specific risk of frailty and fractures in older populations.

If you are taking semaglutide or tirzepatide, be aware that a significant portion of your weight loss (up to 45% for semaglutide) comes from lean mass, not just fat. This is especially risky if you are over 60. Discuss strategies to preserve muscle, such as resistance training or potentially newer combination therapies, with your provider.

Socioeconomic status, demographic factors (sex, age, country of birth), lifestyle habits (binge eating, alcohol use), and specific biomarkers (TSH, triglycerides, calcium, HbA1c) are the strongest predictors of BMI levels, with psychological factors (anxiety/depression scores) having stronger predictive value than self-reported diagnoses.

If you are struggling with obesity, look beyond just calories. Your socioeconomic context, mental health (specifically anxiety and binge eating tendencies), and specific blood markers (like TSH and triglycerides) are powerful indicators of your BMI trajectory. Addressing psychological health through validated screening tools may be more predictive and actionable than relying solely on self-reported diagnoses or medication history.

Verbal instructions directing attention to the triceps (internal focus) significantly increase triceps brachii activation during the bench press, whereas instructions targeting the pectorals do not significantly increase pectoralis major activation.

When performing the bench press, if your goal is to emphasize your triceps, explicitly tell yourself to 'push with your triceps' or 'push your elbows away from each other.' This will increase triceps activation. However, do not expect this instruction to significantly increase chest activation; the chest will work regardless of the instruction. You cannot 'turn off' the chest by focusing on the triceps, nor 'turn on' the chest by focusing on it.

Using a single, universal velocity loss (VL) threshold to prescribe resistance training volume is unreliable and likely leads to variable acute physiological responses and divergent long-term adaptations because the volume of work completed at a given VL threshold varies significantly between individuals.

Do not use a single velocity loss threshold (like 20% or 30%) for everyone in your gym or program. The amount of work you do to hit that speed drop varies wildly between men and women, and between strong and less strong individuals. To ensure consistent training effects, you must individualize velocity loss targets based on sex, training status, and personality traits like emotional stability.

Sex significantly influences the volume of work completed at velocity loss thresholds, with females completing more repetitions than males at the same VL thresholds, while males perform repetitions at higher velocities.

If you are programming for mixed-sex groups, do not assume a 20% velocity loss means the same workload for men and women. Women will likely perform more repetitions to hit that speed drop, while men will maintain higher bar speeds. Adjust your targets or volume expectations based on sex.

Intensive weight loss via energy restriction and increased aerobic exercise induces adaptive thermogenesis (reduced resting energy expenditure beyond mass loss predictions) in both male and female physique athletes.

If you are cutting weight for a competition, expect your metabolism to slow down more than your weight loss would predict. This is a normal biological response called adaptive thermogenesis. It is driven by the energy deficit and increased exercise volume. The good news is that this adaptation is temporary and reverses during recovery.

Male physique athletes lose significantly more lean mass than female athletes during competition preparation, despite similar reductions in fat mass and muscle size.

Men preparing for physique competitions should be aware they may lose more muscle than women during a cut, likely because they reach lower body fat levels. Prioritizing protein and minimizing the depth of the cut may help preserve muscle.

Adaptive thermogenesis is associated with significant hormonal changes, specifically decreased leptin and T3, and reduced resting heart rate.

Low leptin and T3 levels are expected during a cut and contribute to metabolic slowdown. This is a normal hormonal response to energy deficit.

Increasing urinary sodium excretion by 1 gram per day is associated with a significant increase in systolic blood pressure (approx. 1.7 mmHg) and diastolic blood pressure (approx. 0.5 mmHg).

For every additional gram of sodium you consume (roughly 1/3 of a teaspoon of table salt), your systolic blood pressure may rise by about 1.7 mmHg. To mitigate this, ensure your potassium intake is adequate, as the study shows potassium helps lower blood pressure.

Increasing urinary potassium excretion by 1 gram per day is associated with a significant decrease in systolic blood pressure (approx. 1.1 mmHg) and diastolic blood pressure (approx. 0.9 mmHg).

Increasing your potassium intake by 1 gram per day can lower your systolic blood pressure by about 1.1 mmHg. Focus on potassium-rich foods like fruits and vegetables to help counteract the effects of sodium.

A higher sodium-to-potassium ratio (gram-to-gram) is significantly associated with increased systolic and diastolic blood pressure, with the effect being most pronounced in low-salt regions.

Your sodium-to-potassium ratio is a critical determinant of blood pressure. A higher ratio (more sodium relative to potassium) significantly raises blood pressure. To lower your ratio, reduce sodium intake and increase potassium-rich foods, especially if you live in a region with lower salt intake.

GLP-1RAs reduce food intake and body weight by activating POMC neurons and inhibiting NPY/AgRP neurons in the arcuate nucleus (ARC) of the hypothalamus.

GLP-1 medications also work in the brain's 'hunger center' (arcuate nucleus) by boosting 'stop eating' signals (POMC) and reducing 'start eating' signals (NPY/AgRP). This dual action helps reduce overall food intake and body weight.

Discontinuation of anti-obesity medications (AOMs) leads to significant weight regain starting at 8 weeks post-treatment, with the trajectory stabilizing by 26 weeks.

If you stop taking anti-obesity medication, expect to regain weight starting around 2 months later. This is a biological response to the loss of the drug's appetite-suppressing effects, not a lack of willpower. Long-term management likely requires ongoing treatment or intensive lifestyle support to counteract this regain.

Adherence to the Mediterranean diet (MeDi) is associated with improved cognitive performance and a delay in cognitive decline in elderly populations, particularly when enriched with extra virgin olive oil or nuts.

Adopt a Mediterranean-style eating pattern focusing on extra virgin olive oil, vegetables, fruits, whole grains, and nuts. This approach is more effective for cognitive health than taking single supplements. Prioritize high-polyphenol olive oil and moderate wine intake if appropriate for your health profile.

Plant-based diets, particularly those emphasizing nutritious plant foods, are associated with a reduced risk of cognitive impairment and dementia compared to non-vegetarian diets.

Shift your diet to center around plants: vegetables, fruits, whole grains, legumes, nuts, and seeds. This pattern is linked to a significantly lower risk of dementia. Ensure you are eating 'nutritious' plant foods, as less healthy plant-based patterns may not offer the same benefits.